NOTE: ALL TIMES ARE EASTERN. THESE TIPS ARE EMBARGOED UNTIL 8 a.m. ET Saturday, Nov. 7, 2015.

Abstract 27 (Room W414CD)

Life-saving AEDs often in locked buildings when needed

Most public automated external defibrillators (AEDs) are in buildings that aren’t open 24 hours. As a result, bystanders who are near AEDs don’t have access to the life-saving defibrillators in 21 percent of out-of-hospital cardiac arrests, according to a study presented at the American Heart Association’s Scientific Sessions 2015.

Researchers analyzed cardiac arrests that occurred within 100 meters (328 feet) of a public AED in a Canadian city. They then analyzed AED coverage of out-of-hospital cardiac arrest for more than eight years, according to the time of day and day of week.

When there was no 24/7 access to buildings, researchers found AED coverage was diminished more than:

8 percent during the day;

28 percent in the evening; and

48 percent at night.

Most out-of-hospital cardiac arrests in the study (61 percent) occurred during evenings, nights and weekends.

AED access was limited in schools, industrial facilities, recreational facilities and offices, while there was round-the-clock access in long-term care homes and transportation facilities.

Researchers suggest that a facility’s 24/7 access should be considered when choosing public AED locations, and that this information can be used in a mathematical approach to determine public AED locations that maximize coverage (as noted in poster presentation 248; 8:30 a.m. ET, Nov. 8).

Sudden cardiac arrest? Can’t find an AED? There may be an app for that

The earlier bystanders can deliver shocks with an automated external defibrillator (AED) to people who have cardiac arrest outside the hospital, the better their chances are for survival. Although it may be difficult to find community-based AEDs, a new smartphone application helps connect rescuers with lifesaving AEDs and victims with sudden cardiac arrest, according to research presented at the American Heart Association’s Scientific Sessions 2015.

Japanese researchers developed the app, called AED-SOS, which signals co-rescuers in communities when an out-of-hospital cardiac arrest has occurred and where. Co-rescuers then deliver the needed AEDs to the out-of-hospital cardiac arrest scene. Under the simulation study, researchers tested whether the app can shorten the process of finding and delivering AEDs by studying participants who were assigned to either a group with AED-SOS or a group without the app. Both groups participated in scenarios involving mock out-of-hospital cardiac arrests.

Researchers found that among the 52 people they analyzed, the time from recognition of the out-of-hospital cardiac arrest to AED delivery was an average 133.6 seconds in the AED-SOS group, versus 202.2 seconds in the group without the app.

Shortening the time bystanders recognize out-of-hospital cardiac arrest to when they deliver shocks with AEDs could increase survival, researchers said.

Toshihiro Hatakeyama, M.D.; Kyoto University, Kyoto, Japan;

Note: Actual presentation time is 8:30 a.m. ET, Monday, Nov. 9, 2015.

Abstract 15 (Room W414CD)

Video-only CPR training without a manikin still effective

Families trained in CPR using video training without a manikin performed chest compressions similarly six months after their training as those who received video training with manikins, according to research presented at the American Heart Association’s Scientific Sessions 2015.

Researchers studied 571 family members of cardiac patients who completed either video-only CPR training without a manikin or with a video self-instruction kit, including a practice manikin. They compared their CPR skills, including chest compression rate and depth, at six months after the training.

The rates of chest compressions per minute were similar regardless of whether the video training included a manikin or not. Chest compression depth was slightly lower in the group that did not train with a manikin, at 40 millimeters deep, compared to the manikin group, at 45 mm. However, according to researchers, the depths achieved in both groups fall within the 40 mm to 55 mm suggested range for maximum survival benefit.

Researchers said this is the largest study of CPR training and long-term retention among the general public and the findings suggests video-only training is as good an educational tool as video self-instruction with a manikin when it comes to chest compression rate. The difference in chest compression depth might have a minimal impact on survival, given the evidence-based range for maximum survival benefit.

Most adults who survive out-of-hospital cardiac arrests emerge with their brain function intact, even if their resuscitations took longer than previously recommended, according to research presented at the American Heart Association’s Scientific Sessions 2015.

Researchers studied how the duration of prehospital resuscitation impacts survivors neurologically by analyzing attempted resuscitations on people who suffered cardiac arrests in an urban/suburban area from 2005 to 2014.

Of the 3,814 resuscitations analyzed, 12.2 percent of patients survived. Of those, 83.9 percent of the survivors did not have significant neurological complications (normal function or disability that still allows them to live independently and work) from the resuscitations.

About 90 percent of the neurologically-intact survivors were resuscitated in 35 minutes or less, the other 10 percent took longer than 35 minutes.

In general, neurologically intact survivors had an initial cardiac rhythm that was shockable, had a cardiac arrest that was witnessed by a bystander and first regained a pulse while emergency medical services were on the scene rather than in the back of the ambulance or at the hospital.

Hospitalized patients suffering cardiac arrest at night are more likely to have poor neurological outcome, compared to day time patients, according researcher presented at the American Heart Association’s Scientific Sessions 2015.

Researchers studied information about patients’ survivals after in-hospital cardiac arrest at a teaching hospital in Switzerland. They documented that the hospital’s rapid response team was activated for 270 patients with cardiac arrest. Two-thirds of those cardiac arrests occurred during the day shift.

While rapid response team’s reaction times for cardiac arrest were similar during the day and at night, researchers found patients having the cardiac arrests during the day were:

More likely to be witnessed and have an initial shockable rhythm.

More likely to show more favorable neurological outcome than nighttime patients.

Researchers suggest that a delayed recognition of night-time cardiac arrest might explain the poorer neurological conditions of patients after cardiac arrest during the night.

Luca Marengo, M.D.; University Hospital Basel, Basel, Switzerland;

Note: Actual presentation time is 8:20 a.m. ET, Monday, Nov. 9, 2015.

Abstract 15507 (Valencia Ballroom W415CD – Poster 228)

Middle school students learn CPR in single PE class

A one-time, 45-minute educational session on basic life support has the power to greatly improve middle school students’ CPR knowledge and skills, according to a study presented at the American Heart Association’s Scientific Sessions 2015.

Researchers evaluated the use of a 45-minute basic life support class given to 41 eighth-grade students during a physical education class. The instructors taught students about chest compressions and automated external defibrillators (AED) use. Researchers also studied the effect of repeat education by giving half the students a repeat course two months later, but no such course for the others. They tested students’ CPR knowledge and retention before and right after the initial session, as well as two and four months later.

Researchers found a notable boost in CPR skills and knowledge when they compared students’ knowledge before and after the session. Students retained the information at two and four months after the initial session. And while researchers didn’t note a difference in knowledge between students who took the repeat course and those who didn’t, they did report AED usage was better in the repeat education group.

“If schools across the United States invested one 45- to 60-minute period a year for each school year, this would ensure widespread CPR and AED knowledge with minimal cost and loss of school time,” researchers said.

For more news from the AHA’s Scientific Sessions 2015 follow us on Twitter @HeartNews #AHA15.

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